Neurological Disease Produced by Varicella Zoster Virus Reactivation Without Rash

Gilden, Don; Cohrs, Randall J.; Mahalingam, Ravi; Nagel, Maria A.

doi:10.1007/82_2009_3

Cited by 123 publications

(115 citation statements)

References 53 publications

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“…Since the extent and characteristics of the pain did not change when the shingles occurred, we believe that the second episode of NH was compatible with VZV-related neuralgia. In fact, VZV can cause neuropathic pain with cutaneous vesicle formation (shingles) or without skin rash (zoster sine herpete) in both the preherpetic, acute and postherpetic stages (9,10). Importantly, post-herpetic neuralgia also occurs with a consistent location, shape and size (11), similar to that observed in our patient.…”

Section: Discussionsupporting

confidence: 86%

<i>Varicella-zoster</i> Virus Infection and Nummular Headache: A Possible Association with Epicranial Neuralgia

Chen

Lee

et al. 2012

Intern. Med.

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A nummular headache (NH) is a type of primary headache that results from cranial neuralgia without a known cause. We herein report the case of a woman who suffered two episodes of focal headache in the left parietal area with identical characteristics that were compatible with NH. During the recovery phase of the second NH episode, the pain resurged with shingles coinciding with the painful area. The patient's NH subsided in parallel with resolution of the shingles. These findings support a diagnosis of peripheral neuralgia with NH. Latent virus infections, such as Varicella-zoster virus, that frequently cause distal nerve damage in patients with zoster sine herpete may be associated with epicranial neuralgia and NH.

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Section: Discussionsupporting

confidence: 86%

<i>Varicella-zoster</i> Virus Infection and Nummular Headache: A Possible Association with Epicranial Neuralgia

Chen

Lee

et al. 2012

Intern. Med.

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“…3,4 Zoster sine herpete, which has a chronic radicular pain without rash due to varicella zoster virus (VZV) reactivation, should be ruled out from ZM. 7 Our patient did not have a radicular pain and rash on site of disease. However, VZV deoxyribonucleic acid was not performed.…”

mentioning

confidence: 57%

“…3 Also, several types of cutaneous lesions such as granulomatous dermatitis, vasculitis and folliculitis, granuloma annulare, pseudolymphoma, keloid, sarcoidal granuloma, systemic lymphoma, leukemia cutis, lichenoid dermatitis such as lichen planus and sclerosis, cutaneous Rosai-Dorfman disease have been reported on the site of healed herpes zoster lesions, and this reaction is called as Wolf's isotopic response. [5][6][7] Herpes zoster infections may cause atypical delayed-type hypersensitivity reaction to viral antigen or a tissue antigen alteration hypothetically. 4 A few cases of ZM localized on the site of improved herpes zoster infection have been reported previously.…”

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confidence: 99%

Zosteriform Morphea Without History of Herpes Zoster Infection

et al. 2016

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Morphea is a rare connective tissue disorder. Hardening and thickening of the skin due to an increased density of collagen are its characteristic features.1 It has been classified into plaque or circumscribed, linear, generalized, morphea profunda (deep), pansclerotic and combined forms with wide clinical presentation.2 Zosteriform morphea (ZM), which is described as a dermatomal distribution of lesions like herpes zoster clinically, is a rare entity. Most of them have been described on the same area of preceding herpes zoster infection as Wolf's isotopic response. 3,4 In this article, we report a case with usual morphea diagnosed histopathologically at unusual location without history of herpes zoster infection.An 18-year-old healthy, male patient presented with complaints of hardness and discoloration of the skin at the right posteroinferior side of his trunk with a zosteriform distribution of T 10-12 dermatomes, over a period of two years. We detected no characteristic finding in his medical/family history and physical examination except indurated plaque that measured 9x6 cm in diameter with central hyperpigmentation among the xyphoid and umbilicus that extended to the lateral part of the trunk with atrophic lesions in a zosteriform distribution (Figure 1). We detected no history of herpes zoster or other skin lesions on the site of ZM, abnormal skin moisture, suggestive signs of other extracutaneous, musculoskeletal or systemic sclerosis. Serology for varicella-zoster virus tested negative for immunoglobulin M, but positive for immunoglobulin G. Anti-nuclear antibody, anti-human immunodeficiency virus, first-tier immunoglobulin M and immunoglobulin G enzyme immunoassays for Borrelia were negative. A skin biopsy revealed an interstitial lymphoplasmacytic infiltrate which surrounded eccrine coils and distributed among separated deep dermal thickened, hypocellular and swollen collagen bundles, and papillary dermal collagen elastic fibers (Figure 2). Laboratory studies including blood cell count, serum chemistry, and autoantibodies (antinuclear antibodies and antiScl-70 also called anti-topoisomerase 1) were all normal or negative. Clinical and pathological features were consistent with the diagnosis of morphea. A written informed consent was obtained from the patient.Zosteriform term describes the dermatologic morphology attributing to the distribution of herpes zoster. Some diseases such as lichen planus, parakeratosis, common warts, fungal infections, nevus, and skin metastases have been described with this pattern.3 Also, several types of cutaneous lesions such as granulomatous dermatitis, vasculitis and folliculitis, granuloma annulare, pseudolymphoma, keloid, sarcoidal granuloma, systemic lymphoma, leukemia cutis, lichenoid dermatitis such as lichen planus and sclerosis, cutaneous Rosai-Dorfman disease have been reported on the site of healed herpes zoster

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“…Notable exceptions include the following characteristics: atypical rashes, such as disseminated zoster or a minimal or absent dermatomal rash; zosteriform herpes simplex; modified (breakthrough) varicella in vaccinated individuals; and rashes caused by enteroviruses, poxviruses, rickettsia, drug reactions or contact dermatitis; and VZV infection in the absence of a rash. The latter includes, for example, zoster without rash (known as zoster sine herpete, sometimes with or without facial palsy 90 ), meningitis 1,91,92 , stroke 81,[93][94][95][96][97] , myelitis 98 and enteric (gastrointestinal) infections 45,[99][100][101][102] . In these settings, rapid diagnosis is necessary to plan appropriate therapy and public health measures.…”

Section: Diagnosis Screening and Prevention Diagnosismentioning

confidence: 99%